05/10/2023
COCCYDYNIA
Coccydynia or coccalgia, coccygeal neuralgia or tailbone pain, is the term used to describe the symptoms of pain that occur in the region of the coccyx.The pain is most commonly triggered in a sitting position, but may also occur when the individual changes from a sitting to standing position.
✨Ergonomic Adjustments✨
The initial goal of treatment should be focused on providing postural education.Individuals should be taught to correct their sitting posture by sitting more erectly on a firm chair.A proper sitting posture ensures weight is taken off the coccyx and is instead loaded onto the ischial tuberosities and the thighs.Patients should be advised to avoid any positions or movements that might exacerbate their symptoms.
"Physiotherapists may also recommend the use of cushions. Modified wedge-shaped cushions (coccygeal cushions), which can be purchased over the counter, help to relieve the pressure placed on the coccyx during sitting. Donut shaped or circular cushions may also be used"
⚽Manual Therapy:-
The manual therapy techniques suggested in the literature range from massage, stretching, mobilization and manipulation, and may either involve internal or external contact with the coccyx.
〽Internal adjustment:-
Internal techniques may include massage of the levator ani muscle or the coccygeus muscle,joint mobilization while the coccyx is hyperextended to stretch the levator ani, or repeated mobilizations while the coccyx is rotated.
〽External adjustment:-
External techniques may include manipulations of either the coccyx or sacroiliac joint, mobilizations of the sacrococcygeal or intercoccygeal joints, posterior mobilizations to the thoracic spine, and stretching of the piriformis or iliopsoas.
♦Mobilization techniques may be the preferred technique when the goal of treatment is to increase coccygeal mobility.Pelvic floor rehabilitation can be helpful for coccydynia that is associated with pelvic floor muscle spasms
🔹TENS
During TENS, your device delivers a light electrical current that disrupts pain signals from the coccyx to the brain. This solution is ideal for pain management, but tends to wear off several hours after treatment
🔹Ultrasound therapy
(5days per week for about 4week )
◾Exercise to avoid:-
Exercises that put pressure on it - Spin class, Pilates roll ups/rolling like a ball/balancing with your legs lifted, Barre class where you are instructed to tuck. Tightness in the hip rotators and pelvic floor muscles. Kegels - with a coccyx injury you have to be very careful with pelvic floor muscle strengthening.
💉Injection for tail bone:-
Coccygeal injection consisting of direct administration of steroid and local anaesthetic. Ganglion impar injection treats coccyx pain by blocking the pain signals to the brain, and these injections can be both diagnostic and therapeutic
🐋Knee to Chest Stretch:-
Raise the knees toward the ceiling, keeping the feet flat on the floor. Bend the left leg closer into the body and rest the left ankle across the right knee. Loop the hands around the right thigh and gently pull it toward the chest for 30 seconds.
🔳 Surgical options include:
Partial coccygectomy (removal of part of the coccyx — extremely rare).
Total coccygectomy (removal of the entire coccyx — extremely rare)
📎 Coccydynia in Pregnancy:-
because the growing fetus is putting pressure on the bone. Physical therapists recommend you lie on your side when you sleep and sit on a coccyx cushion. Both will help relieve some of the pain by taking pressure off of your coccyx
